Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.06 / $128.13 / $210.27	Facility	26	$65.06	$128.13	$210.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.65 / $349.00 / $588.22	Professional		$247.65	$349.00	$588.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $65.06 / $150.88	Professional	26	$52.46	$65.06	$150.88
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $537.20 / $537.20 / $537.20	Facility	26	$537.20	$537.20	$537.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $360.33 / $641.67 / $2,077.23	Professional		$360.33	$641.67	$2,077.23
Asuris Northwest Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $140.10 / $471.45	Professional	26	$79.45	$140.10	$471.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.82 / $520.23 / $893.05	Professional		$271.82	$520.23	$893.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.28 / $105.02 / $180.66	Professional	26	$57.28	$105.02	$180.66
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $64.06 / $130.37 / $539.79	Facility	26	$64.06	$130.37	$539.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $276.91 / $606.11 / $978.90	Professional		$276.91	$606.11	$978.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.73 / $122.53 / $157.83	Professional	26	$56.73	$122.53	$157.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.01 / $251.57 / $541.02	Professional		$43.01	$251.57	$541.02
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $93.44 / $112.30 / $116.58	Facility	26	$93.44	$112.30	$116.58
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $178.77 / $178.77 / $178.77	Professional		$178.77	$178.77	$178.77
Pacific Source Facility/Professional Professional Modifier 26 Low / Median / High Price $80.55 / $113.10 / $121.53	Professional	26	$80.55	$113.10	$121.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $77.69 / $77.69 / $77.92	Facility	26	$77.69	$77.69	$77.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $401.57 / $602.38 / $729.23	Professional		$401.57	$602.38	$729.23
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.36 / $133.69 / $160.06	Professional	26	$88.36	$133.69	$160.06
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $851.78	Facility	26	$346.39	$346.39	$851.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $364.52 / $530.07 / $727.04	Professional		$364.52	$530.07	$727.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $117.64 / $160.03	Professional	26	$79.45	$117.64	$160.03
United Facility/Professional Professional Modifier Low / Median / High Price $239.89 / $352.25 / $761.73	Professional		$239.89	$352.25	$761.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.08 / $66.45 / $170.98	Professional	26	$53.08	$66.45	$170.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $276.58 / $276.58 / $276.58	Professional		$276.58	$276.58	$276.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $59.51 / $59.51 / $59.51	Professional	26	$59.51	$59.51	$59.51